


and i shall do no harm

by gracieminabox



Category: Star Trek: Alternate Original Series (Movies)
Genre: Euthanasia, Gen, M/M, Medical Procedures, Minor Character Death, Post-Star Trek: Into Darkness
Language: English
Status: Completed
Published: 2017-02-13
Updated: 2017-02-13
Packaged: 2018-09-24 00:36:10
Rating: Teen And Up Audiences
Warnings: Major Character Death
Chapters: 1
Words: 2,957
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/9691901
Author URL: https://archiveofourown.org/users/gracieminabox/pseuds/gracieminabox
Summary: Primum non nocere.





	

**Author's Note:**

  * Translation into Русский available: […и не причиню вреда](https://archiveofourown.org/works/12144570) by [Fandom_Medic_2017](https://archiveofourown.org/users/Fandom_Medic_2017/pseuds/Fandom_Medic_2017)



“Lieutenant Commander McCoy, please rise.”

Len stood on nearly-numb legs and turned dull eyes to the ‘Fleet Medical Board, a panel of five admirals outfitted in their whites like they were about to go see patients after this and not sit behind desks pushing PADDs and terrorizing interns. He straightened his dress grays and came to something resembling attention, cap in hand at his side, and tried not to look like he actively didn’t give a shit what kind of judgment they were about to pronounce against him.

 

_I swear to fulfill, to the best of my ability and judgment, this covenant…_

 

When he got old enough, Len used to go on house calls with his daddy. People sometimes laughed when Len described his father (and later himself) as “just an old country doctor,” but he wasn’t kidding. The twenty-third century, first contact, and all its technological and scientific marvels may have come to pass, but rural Georgia was still rural Georgia. People wanted a doctor right up the road that knew every old ache and pain by heart and would come calling day or night if the need arose, and Len delighted in David McCoy’s comparatively antiquated but still perfectly effective way of doing things, with a lightness and a gentleness that endeared him to his patients.

By the time he was ten, Len had memorized a few different heart rhythms, seen broken bones set in old-fashioned splints, learned how to give a hypo (though his father still wouldn’t let him lay hands on one, _not yet, you fool boy, you’re too damn young_ ), taught himself real old-school cardiopulmonary resuscitation, and had most of David’s safe sex lecture - a mainstay at contraceptive consults - committed to memory. He’d seen a couple babies be born and had heard the crack his daddy’s voice at calling a time of death for an elderly neighbor.

And it was set - Len wanted to be a doctor, just like his daddy.

 

_I will apply, for the benefit of the sick, all measures which are required…_

 

He was fifteen the first time David asked him to leave the house while he treated a patient. It was Mrs. Jackson, who lived a few kilometers away from the McCoys and who, once upon a time, proudly proclaimed to anybody who’d listen that she could trace her ancestry straight back to Robert E. Lee (though, after taking his American history class, Len wasn’t sure why one would admit to that). Len wasn’t sure what was wrong with her, but she was suffering. A lot. Her sentences no longer made sense; her hair was thinning dramatically and falling out in handfuls; she thought her loving adult sons were demons come to drag her to hell; she’d long since lost control of her bowels and bladder.

Len watched from a corner as David examined her with gentle, steady hands, reaching for his tricorder only as a last resort. He made eye contact with Mrs. Jackson’s sons, then turned and shooed Len from the room in a tone that brokered no argument.

It was December, a chilly night (for Georgia, at least), and Len spent the next few hours on the porch, fiddling with his comm, staring at the stars, and engaging in a protracted cost/benefit analysis of sating his curiosity on either what the hell was going on in there or whether David McCoy had any qualms about taking his belt to the backside of a son taller than he was.

Then the coroner’s hovercar pulled up, and Len’s train of thought went eerily quiet.

David’s hazel eyes were haunted on the way home. Len followed him up to David’s study, where David silently poured them both a drink, legal drinking age be damned.

They both knew what happened in the Jackson home tonight, though nobody was talking.

“You gonna get in trouble?” Len asked, extremely quietly. “For breaking your oath?”

David stared unseeing into his lowball glass. “My oath says to do no harm, Leonard,” David rasped. “Lettin’ that woman live like that… _that_ woulda been doin’ harm.”

Len sipped the whiskey with a grimace, smacked in the face with the reality he’d been conveniently ignoring, the reality that medicine wasn't going to be all broken bones and stuffy noses and new babies and peaceful deaths, but sometimes ugly and sour and raw.

 

_I will prevent disease whenever I can but I will always look for a path to a cure for all diseases…_

 

David’s illness progressed quickly. One day, he was bouncing a gurgling baby Joanna on his shoulder, running those same steady, gentle hands through a fine mess of auburn ringlets; a few weeks later, simply going from sitting on the toilet to standing caused him such pain he’d cry out with agony.

Len was running on nothing but coffee and stim hypos and aggravation. He’d bargained with his bosses at Atlanta Grace to cut his ER shifts to eights instead of twelves, but as soon as his shifts ended, he’d hightail it to the research lab on the fourth floor. He’d commandeered a corner of the lab after his father’s diagnosis was confirmed and snarled menacingly at anyone who tried to approach when he was working.

He tried gene therapy. He tried every chemical compound he could think of. He tried a remyelination technique that he pulled straight out of his ass. He tried sim after sim after sim. The thing was, pyrrhoneuritis was still a remarkably mysterious disease, even by twenty-third century medical standards. Len was trying to reach a destination without knowing exactly from where he was departing.

He checked on David at least once a day, but he’d lost track of how long it had been since he’d been home to his wife and baby girl - four, five days? - and he knew that, other than the odd thirty-minute catnap in the on-call room, it’d been longer than that since he’d slept. Len was coming apart at the seams; he knew it, but he buried the thought deep in the recesses of his mind, not to be disturbed.

 

_I will not be ashamed to say “I know not”…_

 

That night, he went to check on David, who was in too much pain to even open his eyes and see his son. His reflexes were shitty. He said his blood felt itchy. His voice was small, whimpery. He sounded like a child, and it scared the hell out of Len.

“I’m tired, son,” David whimpered, trying and failing to squeeze Len’s hand. “You’ve gotta end this for me.”

“Dad, I’m working as hard as I can,” Len murmured, resting a hand on his father’s brow, crinkled in pain. “I’ll find a cure. I promise.”

“Leonard,” David breathed insistently, “I need this to end.”

“I’ll make it end.”

David shook his head, agitated. “You know what I’m asking for, you damn stubborn boy.”

Len did. “No. _No._ I’m gonna find a way. I’m gonna cure you.”

“How?”

Len swallowed. “I don’t know.”

“Five hundred of hydromorphone, Leonard. ’s how I always did it.”

“Jesus, Dad - ”

“You want a cure? There’s your cure.”

“Goddammit, Dad - ”

“Son,” David implored, and the begging, pleading tone in his voice shook Leonard to his bones, _“do no harm.”_

David Joseph McCoy died peacefully at 4:47 the following morning, Len at his side.

 

_Above all, I must not play at God…_

 

When Jocelyn and Len were duking it out for custody of Joanna, one of the (many) words Jocelyn used to describe her soon-to-be-ex-husband was “alcoholic.” Which was a profound exaggeration, in Len’s estimation. Sure, he was a good Georgia boy who liked his bourbon with dinner, but that was hardly reason to pathologize him. (Never mind the spectacular bender he went on after euthanizing his daddy; those were special circumstances, and if Joss thought she wouldn’t lose herself in a bottle in the same situation, she was a goddamn fool.)

Len’s attorney, some chickenshit hotshot barely older than Len himself, heavily implied that Len’s attendance at a handful of AA meetings would make him look better in front of the judge. Len rolled his eyes; he did not need some goddamn twelve-step program. His attorney then made the point that this could make or break Len’s ability to see his baby girl on a regular basis, and, well, _when and where are they and how many do I need to go to?_

So Len found himself spending twelve consecutive Thursday evenings sitting in the basement of what he thinks used to be a synagogue way up in Toco Hills, sipping tepid coffee and listening to one sob story after another. Len wasn’t unsympathetic; he understood addiction, at least from a clinical, academic perspective - it’s just that this wasn’t _him_ , he didn’t feel he had much to take from the exercise.

One night, a young woman with hair almost exactly Joanna’s shade came up to speak. Her hands were a little shaky, but her voice was clear as she spoke about her Third Step. She kept using this phrase, and for some reason, it stuck in his mind: _do the next right thing._

It seemed simple. Too simple, Len thought. That’s how medicine worked all the time, wasn’t it? Do the next right thing. Your patient faints, you catch ‘em. Your patient’s not breathing, you vent ‘em. Your patient’s dying, you save ‘em.

Well, unless they’re your daddy and they’re begging you for a hypo full of narcotics.

Len crushed the paper coffee cup in his hand.

“Sometimes,” the redheaded girl said, “doing the next right thing is the last fucking thing I wanna do. I don’t _wanna_ come to a meeting or go to class or go to the gym; I _wanna_ go score, I _wanna_ go get blackout drunk. But I’ve gotta stay on track; I’ve gotta focus on doing the next right thing, even if I hate it. Doesn’t have to be any other reason to do it, other than that it’s _right_.”

Len swallowed hard.

 

_Above all, I must not play at God…_

 

Seeing Jim lying in that bodybag was the biggest punch to the gut Len had ever experienced. Bigger than his mother’s passing, bigger than David’s plea for death, bigger than Joss’ petition for divorce - the only thing that came vaguely close was the blow of the severely restricted custody arrangement. Because Jim wasn’t supposed to be dead. Jim wasn’t _ever_ supposed to be dead. For all the effort Len put into patching him up and keeping him alive, there was a part of Len deep, deep inside that held Jim to be immortal. After all, Jim was light and color and joy and _life_. How could life possibly be dead?

He slumped into his desk chair, wondering why the hell a world without Jim Kirk would dare go on, cursing the chronometer for inexplicably continuing to tick in the absence of Jim’s sunlight. As CMO, it was Len’s responsibility to pronounce Jim’s death. It was Len’s responsibility to do Jim’s autopsy, to weigh and measure Jim’s liver and lungs and boundless brimming heart and then prepare a report that didn’t begin to encompass exactly what was lost when Jim was lost. Jim, that bright, beautiful, uniquely gifted kid, had already saved Earth; how many worlds, how many _trillions_ of lives, could only be saved by Jim Kirk’s genius mind and fearless soul and flat-out refusal to accept defeat?

Len couldn’t stomach it. His eyes welled, his chin wavered, and he thought desperately, painfully, _I never even told him -_

And then the dead tribble purred.

Len’s eyes flew up to the monitor as it literally and metaphorically sprung to life - cardiac activity, respiration, metabolism - and in the space of a single breath, Len was assaulted with a memory of a redheaded girl at an AA meeting four years ago.

_Do the next right thing._

And then, his father’s voice.

_Do no harm._

So Len did.

“Get me a cryo tube, _now!”_

 

_Above all, I must not play at God…_

 

Once the Enterprise stopped falling from the sky, once Jim’s most rudimetary metabolic functions had resumed (even though the biobed was still pumping his blood and oxygenating his brain), once they were back at Starfleet Medical, word of what the intrepid Dr. McCoy did circulated in a hurry. Not that Len knew this, of course; he didn’t leave Jim’s bedside for anything but the bathroom, and he was shamefully close to cathing himself so he didn’t have to leave to piss, too. He didn’t sleep more than twenty minutes at a stretch and only ate what Nyota brought him, grimacing as she refused to leave until she saw him clean his plate.

Jim’s return to the world of the living was a two-steps-forward, one-step-back affair. He opened his eyes for the first time eleven days after walking into the warp core, and Len trembled from head to toe at the sight of that electric blue, brief as it was.

Day thirteen brought Jim’s first word after rebirth: “Bnnnnnns.” Jim didn’t open his eyes, just breathed out that damn fool nickname, and Len hadn’t heard a sweeter sound since Joanna’s first cry. Without thought, he bent down and kissed Jim right between the eyes, not giving a royal fuck that Spock and Hikaru were right there. (They wisely said nothing.)

 

_Above all, I must not play at God…_

 

On day fourteen, Spock slid almost silently into Jim’s room. Len sat next to Jim’s bed, flicking his eyes between Jim’s face and the monitors above his head. Scotty sat his own vigil at the foot of Jim’s bed.

“Doctor,” Spock said softly.

“What is it, Spock?” Len asked, not taking his eyes off Jim’s O2 sats.

“I have been asked to convey a message,” Spock answered impassively. “Your presence will be required at 1300 hours tomorrow afternoon at a hearing to be convened by the medical board regarding your actions in saving Captain Kirk’s life.”

Len snorted. “Which board?” Len actually held three separate medical licenses - one for the State of California, one for the Federation, and a third for Starfleet, because what would a humanitarian and peacekeeping armada be without more bureaucratic red tape?

“Starfleet.” As Spock explained it, California had no idea how to handle a doctor who’d actually resurrected someone, so they kicked it upstairs. The Federation considered it “a military affair” and passed the buck to Starfleet.

(Scotty went full Scots after hearing the words “military affair” and cursed a blue streak, bringing Len the only laugh he’d gotten in a damn long while, what with Jim pseudo-dead and all.)

Spock’s tone became ever so slightly icier, in a way that only someone who knew him well would be able to identify. “It is…likely…that this hearing will involve disciplinary action.”

Once upon a time, the idea of disciplinary action by a medical board would’ve struck terror into Len’s heart. But after this? Len didn’t take his eyes off that little blip on the monitor that meant Jim’s neural tissues were remembering how to behave normally. “Spock,” he said softly, “I’m fresh out of fucks to give about _disciplinary action.”_

That evening, Nyota brought Len’s dress uniform to the hospital, freshly pressed, and hung it in the en suite bathroom. Chekov agreed to stay with Jim until the hearing was over and Len could return to Jim’s bedside, assuring Len repeatedly that he would comm him with any change, no matter how minor.

The following afternoon, Len donned his dress uniform, not bothering to try to conceal the bags under his eyes or the pallor of his skin. He kissed Jim’s forehead - _it’s warm, it’s warm, it’s warm, his skin is warm!_ \- and went to meet his fate.

 

_Above all, I must not play at God…_

 

“Lieutenant Commander McCoy, before we pronounce our decision, do you have anything to say in your defense?”

Len couldn’t not scowl. “I maintain that I have no actions to defend, _Doctors_ ,” he intoned, with emphasis on the title in lieu of the rank. “I made a medical judgment that saved the life of my commanding officer, who is directly responsible for saving billions of lives. The oath I took directs me to do no harm. To permit Captain Kirk’s death would be to do tremendous, irreparable harm to the galaxy.”

Somehow, though he couldn’t scientifically say how, Len could _feel_ Spock’s approval radiating into his back.

The head of the panel, an older Andorian chan, nodded. “Noted for the record. Lieutenant Commander Leonard McCoy, this panel finds you in violation of the Starfleet Biomedical Ethical Code of Conduct, section three, subsections seventeen through twenty. It is therefore ordered that your license to practice medicine as a member of Starfleet be, and it hereby is, suspended for a period of six Terran months - ” the Andorian’s face took on an unexpected look of sympathy “ - at which time your Starfleet medical license shall be reinstated with prejudice.”

Len blinked, breathed, felt the lingering _it’s warm it’s warm it’s warm_ of Jim’s skin against his lips. _Six months. I can do six months._

“Be aware, Lieutenant Commander, that this order does not extend to either your Federation or your State licenses to practice medicine. You remain a board-certified physician for the next six months.”

 _Which means I can still treat Jim_ , which was really, _really_ all that mattered.

“This hearing is adjourned.”

 

_Above all, I must not play at God…_

 

That afternoon, Len heard a great gasping breath and saw Jim’s eyes, bright and blue and goddamn _alive_ , fly open, seeking, searching, asking, imploring, _living._

“Oh, don’t be so melodramatic,” Len scoffed, swallowing back his heart. “You were _barely_ dead.”

 

_Above all, I must not play at God…_


End file.
